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Obese Patients Benefit From Knee Replacement, Surgery Should Not Be Denied in UK LONDON -- July 23, 2008 -- Obese patients benefit greatly from total knee arthroplasty (TKA), and there is no justification for denying these patients the surgery, according to a small study published ahead of print in the Annals of the Rheumatic Diseases. According to background information from the article, in some parts of the United Kingdom, knee replacement surgery is offered only to patients who are not clinically obese (body mass index [BMI] <30 kg/m2) on the grounds that obesity is itself a risk factor for knee osteoarthritis. The research team monitored the progress of 325 people aged over 45 years for approximately 6 years after they had had knee replacement surgery. Their progress was compared with that of 363 general practice patients, matched for age and sex, who had not had knee replacements. At the start and end of the study, all participants completed a validated questionnaire designed to assess their mobility, mental health, and wellbeing. Patients said they had significantly worse mobility than those in the comparison group, scoring an average of 20 compared with 89. When researchers restricted their analysis to participants who were obese, they saw improvement, and BMI did not appear to be a significant factor in this. However, there was a stark contrast in mobility among those who had and had not had the surgery. Mobility score rose 3 points among those who had surgery but fell 36 points among those who had not had a knee replacement. In addition, among those aged over 75 years who had not had the surgery, mobility score fell 40 points. "The long-term improvement in physical function that we observed in patients who have undergone TKA is striking when set against the decline that occurred in [the comparison group]," wrote the authors. "These benefits extend to patients [who are obese] and, provided appropriate selection criteria are applied with regard to fitness for surgery, there seems no justification for withholding from patients who are obese." SOURCE: British Medical Journal E-mail this page to a friend or colleague! To print, use this version